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Voice > Spasmodic Dysphonia vs. Muscle Tension Dysphonia > Flashcards

Spasmodic Dysphonia vs. Muscle Tension Dysphonia Flashcards

1
Q

Dystonia

A

neurological disorder that is characterized by involuntary muscle contractions which force certain parts of the body into abnormal, sometimes painful, movements or positions

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2
Q

Focal Dystonia

A 
Affects only one part of the body:
Blephrospasm
Cervical Dystonia-torticollis
Oromandibular Dystonia
Writer's cramp
Hemifacial spasm
Laryngeal Dystonia--Spasmodic Dysphonia
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3
Q

Laryngeal Dystonia

A

Adductor
Abductor
Mixed
Tremor

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4
Q

Cause of Laryngeal Dystonia

A

unknown
originates in basal ganglia
onset in some cases may be triggered by trauma
Genetic factor is suspected in 10-20% chromosome 9

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5
Q

Incidence of Laryngeal Dystonia

A

30,000-50,000
generally between 40-50 years of age
more women than men

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6
Q

Components of a differential diagnosis of Spasmodic Dystonia

A 
Team: SLP, Oto, Neuro
History
Perceptual 
Stroboscopy
EMG
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7
Q

History Component

A

Failure of multiple treatments
better when singing, laughing, yawning, yelling, whispering and with alcohol
worse with stress, on phone, with continuous talking

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8
Q

Videostroboscopy

A

Normal (periodic, symmetrical mucosal wave, full length of VC without hyperadduction)

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9
Q

Aductor Laryngeal Dystonia Perceptual Eval

A

voice is strained, strangled and choked in quality
Often abrupt initiations and terminations of voicing resulting in voice breaks
effortful speech, fatigue
voice breaks on vowels and voiced consonants
continuum of severity
compensatory strategies

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10
Q

Aductor Laryngeal Dystonia Videostroboscopy

A

aperiodic mucosal wave
decreased amplitude
intermittent FVC approximation
intermittent anterior/posterior compression

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11
Q

Abductor Laryngeal Dystonia Perceptual Eval

A 
whispered, breathy quality of voice
breathy voice breaks
effortful speech, fatigue
voice breaks typically on unvoiced consonants
Continuum of severity 
Compensatory strategies
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12
Q

Abductor Laryngeal Dystonia Videostroboscopy

A

effort to maintain closure in sustained phonation
Increased amplitude
Abduction of vocal cords during voice breaks

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13
Q

Mixed Laryngeal Dystonia Perceptual Eval

A

symptoms of both adductor and abductor laryngeal dystonia

Often but not always a predominance of adductor symptoms

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14
Q

Mixed Laryngeal Dystonia Videostroboscopy

A

intermittent FVC approximation and anterior posterior compression during voice breaks
intermittent abduction of TVCs during voice breaks

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15
Q

Tremor Laryngeal Dystonia Perceptual Evaluation

A

shaky voice, often unable to sustian steady sound
Tremor may be consistent or intermittent
Often accompanied by symptoms of adductor laryngeal dystonia

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16
Q

Tremor Laryngeal Dystonia Videostroboscopy

A

Presence of intermittent or consistent tremor
Tremor between 3-6 Hz
May occur alone, with hyperadduction during breaks or with abduction of VCs during breaks

17
Q

Muscle Tension Dysphonia

A

implies any increase in laryngeal muscle tension resulting in a voice disorder

18
Q

Muscle Misuse Voice Disorders

A

Laryngeal isometric
Lateral contraction
Anteroposterior supraglottic contraction
Vocal cord splinting

19
Q

Vocal Cord Splintin

A

conversion aphonia/dysphonia
psychogenic dysphonia with bowed vocal folds
habituated hoarseness

20
Q

Potential Misdiagnoses of Muscle Tension Dysphonia

A

Adductor laryngeal dystonia

Abductor larygeal dystonia

21
Q

Spasmodic Dystonia

A

failure of multiple treatments
better with winging laughing, yawning yelling whispering and with alcohol
worse with stress on the phone and with continuous talking
worse voice with loud and low pitched voice
better voice with soft and high pitched voice

22
Q

Muscle Tension Dysphonia

A

+/- response to treatment
rarely better with singing or yelling or with alcohol
notice no difference on the phone–worse with overuse
no effect with loud and low pitched voice
No effect with soft and high pitched voice

23
Q

Speech Therapy

A

MTD likely responds to therapy
SD reveals itself (breaks) during therapy
IF no change from therapy consider Botox

24
Q

Botox treatment

A

Successful response=SD

Extreme side effects=MTD

25
Q

Electromyography (EMG)

A

done in conjunction with an electromyographer
assists in confirming diagnosis
“mapping” of involved muscles

26
Q

What are the four major types of laryngeal dystonia?

A

adductor
abductor
mixed
tremor

Voice (6 decks)

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